Who lost weight?

The results of the latest Heart Scan Blog poll are in.


I went wheat-free and I . . .


Gained weight 6 (3%)

Lost no weight 41 (21%)

Lost less than 10 lbs 28 (14%)

Lost more than 10 lbs 34 (17%)

Lost more than 20 lbs 22 (11%)

Lost more than 30 lbs 28 (14%)

I'm still losing weight! 30 (15%)

(189 respondents)


This means that, by eliminating wheat:

24% had no success

31% had moderate success (less than 10 lbs or more than 10 lbs)

25% had extravagant results with 20 lbs or more lost


It would be interesting to know where along the weight-loss spectrum the last category, "I'm still losing weight," group falls. (Anyone with a good story please speak up!)

I believe we can conclude from this casual exercise that, as a simple strategy, wheat elimination is surprisingly effective.

Why would 3% gain weight? Well, without knowing the details, there are several possible explanations:

1) Weight gain developed through other foods. For instance, I've had people eliminate wheat only to replace it with fattening gluten-free alternatives. Remember: wheat-free is not gluten-free. Others load up on the wrong foods, e.g., Craisins and other dried fruit; overdo dairy; or snack on wheat-free but unhealthy foods like ice cream and chips.

2) Too much alcohol

3) Hypothyroidism--A lot more common than you'd think. In fact, this has been the case with a majority of people who have done everything right, yet either failed to lose weight or gained weight.

Those are the biggies.

I'd like to hear your personal stories of wheat elimination--the ups and downs, your success or failure, how you felt during the process, how easy or difficult, your eventual results. Just post them as a response to this blog post.

A niacin primer

A reader of Life Extension reminded me of a piece I wrote about niacin a couple of years back.

Anyone desiring a primer on how and why to use niacin to correct lipid and lipoprotein patterns might find this useful.

While some people, no matter what they do, cannot tolerate niacin (about 10% of people), many others enjoy spectacular benefits.


Q: I recently had a cholesterol profile blood test and learned that I may be at risk of heart disease because my levels of beneficial HDL (high-density lipoprotein) are too low. I read that niacin could help increase my HDL, but my doctor said niacin is dangerous. Whom should I believe?

A: Your doctor would be right—if we were still living in 1985. Since then, however, we have learned how to use niacin (vitamin B3) safely and effectively. Unfortunately, many physicians have not yet caught up, or are still trapped by the idea that cholesterol-lowering statin drugs are the only way to decrease cardiovascular disease risk. I have personally prescribed niacin for thousands of patients as part of our program to reverse coronary disease. In fact, niacin is the closest thing we have available to a perfect treatment that corrects most of the causes of coronary heart disease.

Continued here.

What would life be like . . . ?

What if coronary heart disease could be prevented--no eliminated--applying methods that were accessible, easy, and cheap?

What if coronary heart disease and, thereby, angina, heart attack, sudden cardiac death, ventricular tachycardia, heart failure, and the cerebrovascular equivalent, stroke, could be eliminated using readily available tools available to virtually everyone in the U.S.? And, over a year, it cost less than a once-a-week latte at Starbucks?

How would the healthcare landscape change? What would become of hospitals, manufacturers of the billions of dollars of hospital equipment necessary to supply the cardiovascular hospital industry (e.g., stent manufacturers, catheter manufacturers, defibrillator and pacemaker manufacturers, pharmaceutical manufacturers who no longer have to produce the volume of antiplatelet agents, inotropic drugs, antiarrhythmic agents, etc.)?

How would our lives change? What would the end of life look like if people stopped dying of heart attack, sudden cardiac death, congestive heart failure at age 55, 65, or 75, but lived out their lives to die of something unrelated?

What if the solution had little or nothing to do with drugs but evolved from simple nutritional strategies, supplements meant to correct the deficiencies that accompany modern lifestyles, and a few unique strategies targeted towards the genetic predispositions that lead to heart disease?

What if all this were possible at a cost of a few hundred dollars per year?

It would certainly be a cataclysmic change. Hospitals would shrink to a small remnant of their current gargantuan, dozens-per-city presence. The need for hospital staff would be slashed by over half. The rare cardiologist would tend to congenital heart disease sufferers and other unusual forms of heart disease and he or she might have a colleague or two in all of a major city.

Healthcare costs would plummet, no longer having to sustain the enormous cardiovascular healthcare machine of hospitals, staff, industry, and long-term care. Health insurance, private or public, would drop by 50%.

It would free up nearly a trillion dollars that could be redirected towards other pursuits, like schools and research. Extraordinary leaps forward in quality of life and science would emerge, given that magnitude of funding.

It's not as grand a thought experiment as Alan Weisman's The World Without Us, in which he imagines what the world would be like without humans altogether.

How long would it take to recover lost ground and restore Eden to the way it must have gleamed and smelled the day before Adam, or Homo habilis, appeared? Could nature ever obliterate all our traces? How would it undo our monumental cities and public works, and reduce our myriad plastics and toxic synthetics back to benign, basic elements?

But I believe this thought experiment--what would life be like without heart disease because it was eliminated using inexpensive tools-- is more plausible, more likely to occur. In fact, it has already begun to occur.

See those vines growing up the side of the hospital?

Are jelly beans heart healthy?

Total Fat

3 g or less

Less than 6.5 g





Saturated Fat



1 g or less

1 g or less





Cholesterol

20 mg or less

20 mg or less





Sodium

480 mg or less per RACC* & labeled serving

480 mg or less per RACC* & labeled serving





Nutrients

Contain 10 percent or more of the daily value of 1 of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber



Contain 10 percent or more of the daily value of 1of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber





Trans fat

Less than 0.5 g per RACC* and labeled serving



Less than 0.5 g per RACC* and labeled serving





Whole Grain

N/A



51 percent by weight/RACC*







Minimum Dietary Fiber



N/A

1.7 g/RACC of 30 g

2.5 g/RACC of 45 g

2.8 g/RACC of 50 g

3.0 g/RACC of 55 g





(RACC=Reference Amount Customarily Consumed)

Thyroid correction: The woeful prevailing standard

Rich has been taking Synthroid or levothyroxine for many years.

When Rich came to my office for continuing management 10 years after his bypass surgery, I checked his thyroid panel:

TSH 7.44 uIU/L

Free T4 1.88 ng/dl (Ref range 0.80-1.90 ng/dl)

Free T3 2.0 pg/ml (Ref range 2.3-4.2 pg/ml)


Rich's thyroid hormone distortions--high TSH, low T3--are sufficient to account for a tripling of heart attack risk long-term.

As Richs' thyroid was being managed by his primary care physician, I notified this doctor of Rich's panel. He therefore increased Rich's levothyroxine from 75 mcg per day to 100 mcg per day. Another thyroid panel several months later showed:

TSH 0.98 uIU/L

Free T4 2.38 ng/dl

Free T3 2.0 pg/ml



As you would expect, increasing the intake of the T4 hormone (levothyroxine) increased free T4 and suppressed TSH.

But what about T3? It's unchanged.

Indeed, Rich says that he feels no better and, in fact, wakes up in the morning foggy and requires a nap in the afternoon.

In my experience, the majority (approximately 70%, but not 100%) experience subjective improvement when T3 is added in some form and the free T3 level is increased. While the data (summarized here) are conflicted on whether there is objective benefit to T3 management and supplementation, there seems to be a poorly-quantified subjective improvement.

Rich's increased levothyroxine dose decreased (calculated) LDL cholesterol by 10 mg/dl. Based on my experience, I'll bet that his lipid panel would likely be further improved with T3 correction.

What I find incredible is the absolutely rabid resistance waged by primary care physicians and endocrinologists against this notion of T3, mostly due to fears of the remote likelihood of inducing atrial fibrillation and osteoporosis, while they are ready to prescribe lifelong statin drugs without a moment's hesitation.

Launch of new Track Your Plaque newsletter: Cardiac Confidential

Track Your Plaque has just launched a new version of our newsletter. We call it Cardiac Confidential.

Cardiac Confidential is meant to be a no-holds-barred, go-for-the-throat exposé of the world of heart disease. We will expose the dishonest, reveal what we view as the underlying truth. We'll even have an occasional "undercover" report of what goes on in hospitals and the go-for-the-money world of heart procedures.

Read the first issue here (open to everyone) in which "Laurie" describes her encounter with a sleazy, profiteering cardiologist. She survives, but not without paying a dear price.

Thyroid: Be a perfectionist

If you'd like to reduce LDL cholesterol with nearly as much power as a statin drug, think thyroid.

When thyroid is corrected to ideal levels, LDL cholesterol drops 20, 30, 40 mg/dl or more, depending on how poor thyroid function and how high LDL are at the start. The poorer the thyroid function (the higher the TSH or the lower the T3 and T4) and the higher the LDL cholesterol, the more LDL drops with thyroid correction.

(For those of you minding LDL particle size, such as Track Your Plaque Members, the "dominant" LDL species will drop: If you are genetic small LDL, small LDL will drop. If you have mostly large LDL because of being wheat-free and sugar-free, then large LDL will drop.)

One of the problems is that many healthcare providers blindly follow what the laboratory says is "normal" or the "reference range," which is usually nothing more than a population average (actually the mean +/- 2 standard deviations, a common method of developing references ranges). In other words, a substantial degree of low thyroid function, or hypothyroidism, can be present when your doctor adheres to the reference range provided by the laboratory.

What does it mean to achieve ideal thyroid status? My list includes:

--Normal oral temperature of 97.3 F first upon arising. (The thyroid is the body's thermoregulatory organ.)
--TSH 1.0 mIU/L or less
--Free T3 upper half "normal" range
--Free T4 upper half "normal" range
--You feel good: mental clarity, energy, upbeat mood. You lose weight when you try.

Iodine replacement should be part of any thyroid health effort. Iodine is not an optional trace mineral, no more than vitamin C is optional (else your teeth fall out). The only dangers to iodine replacement are to those who have been starved of iodine for many years; increase iodine and the thyroid can over-respond. I've seen this happen in 2 of the last 300 people who have supplemented iodine.

In my view, neglecting T3 replacement is absurd. While it is not clear to me why many otherwise healthy people have low T3 at the low range of "normal" or even in the below-normal range, people feel better and have better health--faster weight loss, reduced LDL, reduced triglycerides, they are happier and enjoy more energy--when T3 is increased to the upper half of the reference range. (Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)

It pays to be a perfectionist when it comes to thyroid. Not only do you feel better, but LDL cholesterol can drop with a statin-like magnitude, but with none of the adverse effects.

If interested, Track Your Plaque offers fingerstick blood spot testing that you can perform in your own home. Each test kit will test for: TSH, free T3, free T4, along with a thyroid peroxidase antibody (a marker for Hashimoto's thyroiditis, an autoimmune inflammatory condition of the thyroid).

Nutrition Syllogism

What do you think of these chains of logic?

Cyanide is a potent lethal poison; carbon monoxide is a less lethal poison.
Therefore: plenty of carbon monoxide is good.




Having uterine cancer is a bad thing. Having uterine fibroids is a less bad thing.
Therefore: plenty of uterine fibroids are good.



These are obvious examples of seriously flawed logic. Students of logic and philosophy will recognize the above erroneous sequences as examples of the twisted arguments often used to persuade an argumentative opponent of the logic of a premise. As long ago as 335 B.C., Greek philosopher, Aristotle, recognized the pitfalls of thinking in such arguments. You think we’d know better by now.

Try this one:

White enriched flour is a bad for health; whole grains are less bad for health.
Therefore: plenty of whole grains are good for health.



Ouch!

In the 1960s, we all ate hot dogs on white buns, white flour Wonder Bread® sandwiches, Mom made cookies and cupcakes with white flour. Then, during the 1970s and 1980s, clinical studies were performed demonstrating that whole wheat and whole grains reduced colon cancer, high blood pressure, diabetes, and heart disease compared to white flour. In other words, add back fiber and B vitamins and health benefits develop: No argument here.

Therefore: whole grains must be good for health. Further, lots of whole grains?unlimited quantities of whole grains many times per day, every day?must be even better. Even the USDA says so on their nutrition pyramid, with 8-11 servings of grains per day, 4 of which should be whole grains, at the widest portion of the pyramid.

But what happens when you follow this logic through and fill your diet with whole grains?

Look around you and it’s easy to see: Appetite increases, people become obese, blood sugar increases, diabetes develops, HDL cholesterol plummets, triglycerides skyrocket, inflammatory patterns (e.g., c-reactive protein, or CRP) increase, small LDL (the number one cause for heart disease in the obese U.S.!) shoots through the roof.

I would no more fill my diet with “healthy whole grains” than I would close my garage door with the car running.

Is pomegranate juice healthy?


Pomegranate juice, 8 oz:

Sugars, total 31.50 g

Sucrose 0.00 g

Glucose (dextrose) 15.64 g

Fructose 15.86 g




In your quest to increase the flavonoids in your diet, do you overexpose yourself to fructose?

Remember: Fructose increases LDL cholesterol, apoprotein B, small LDL, triglycerides, and substantially increases deposition of visceral fat (fructose belly?). How about a slice of whole grain bread with that glass of pomegranate juice? The Heart Association says it's all low-fat!


(Coming on the Track Your Plaque website: A full in-depth Special Report on fructose in all its glorious forms and whether this is truly an issue for your health. Fructose tables and the scientific data to establish a safe "threshold" value will be included.)

Image courtesy Wikipedia

Honeydew melon


Honeydew melon:

Sugars, total 51.97 g

Sucrose 15.87 g

Glucose 17.15 g

Fructose 18.94 g

Because sucrose is half fructose (the other half is glucose), there are approximately 26 grams of fructose per one-half honeydew melon.



Image courtesy Wikipedia
Vitamin D: Deficiency vs optimum level

Vitamin D: Deficiency vs optimum level

Dr. James Dowd of the Vitamin D Cure posted his insightful comments regarding the Institute of Medicine's inane evaluation of vitamin D.

Dr. Dowd hits a bullseye with this remark:

The IOM is focusing on deficiency when it should be focusing on optimal health values for vitamin D. The scientific community continues to argue about the lower limit of normal when we now have definitive pathologic data showing that an optimal vitamin D level is at or above 30 ng/mL. Moreover, if no credible toxicity has been reported for vitamin D levels below 200 ng/mL, why are we obsessing over whether our vitamin D level should be 20 ng/mL or 30 ng/mL?

Yes, indeed. Have no doubts: Vitamin D deficiency is among the greatest public health problems of our age; correction of vitamin D (using the human form of vitamin D, i.e., D3 or cholecalciferol, not the invertebrate or plant form, D2 or ergocalciferol) is among the most powerful health solutions.

I have seen everything from relief from winter "blues," to reversal of arthritis, to stopping the progression of aortic valve disease, to partial reversal of dementia by achieving 25-hydroxy vitamin D levels of 50 ng/ml or greater. (I aim for 60-70 ng/ml.)

The IOM's definition of vitamin D adequacy rests on what level of 25-hydroxy vitamin D reverses hyperparathyroidism (high PTH levels) and rickets. Surely there is more to health than that.

Dr. Dowd and vocal vitamin D advocate, Dr. John Cannell, continue to champion the vitamin D cause that, like many health issues, conradicts the "wisdom" of official organizations like the IOM.

Comments (20) -

  • Anton

    12/19/2010 2:20:07 AM |

    Thanks for your great blog, and for your interest in Vitamin D.

    Along with doctors Dowd and Cannell, add Dr. Holick as another pioneer in Vitamin D. research.

    http://www.vitamindhealth.org/

  • Anonymous

    12/19/2010 4:58:25 AM |

    I bet natural vitamin d is far superior to oral supplementation.  I think vit D absorbtion is optimized by low carb, but you also need some sunlight added into the picture.

  • Dr. William Davis

    12/19/2010 1:59:13 PM |

    Hi, Anon--

    Where I live, it's been around 10 degrees Fahrenheit for about two weeks straight. Probably too cold to lay out in a bathing suit.

    For many of us, supplementation is the only choice.

    Also, don't forget that the majority of people after age 40 have lost much of their ability to activate vit D in the skin.

  • kellgy

    12/19/2010 5:02:25 PM |

    I just added his book to my wish list and it will be my next read. I am beginning to wonder why don't we seek to reach serum vitamin D somewhere between 100-150 range. Has there been any research indicating any response to these levels? Even with all the recent research focusing on vitamin D, it would be nice to understand overall health responses at varying degrees of serum content from deficiency to toxicity. We need a wider perspective to draw from.

    BTW, an update: 110 pounds and counting . . . My BMI is about to fall into the normal range and my health has never been better!

    This is an unusual thought. Sitting in front of a very warm and soothing fire last night, I was wondering how my skin reacts to the radiation, aside from the warmth and relaxation benefits.

  • IggyDalrymple

    12/20/2010 3:07:51 AM |

    My level dropped 20 points when I reduced my intake from 10,000 iu/day to 5,000 /day.  I went back to 10,000 and now I'm at 63 ng/ml.  I'll stick with 10,000 iu unless I exceed 100 ng/ml.

  • Susanne

    12/20/2010 7:06:08 AM |

    I wonder if there is not a missing piece to the puzzle of vitamin D deficiency in relation to adequate iodine levels.  I have appended text from the website Iodine4health.  In it Dr. Vickery noticed a connection between the two:

    ”I have also noted an apparent connection between bringing sufficient iodine to a bromine plugged thyroid, and the vitamin D metabolism of the body. Although I am unaware of the exact mechanism, it seems clear that the calcitonin/parathyroid hormone/Vitamin D/calcium balance in the body changes as people on iodine loading programs often register as vitamin D deficient when they did not previously."

    I believe this to be my case.  I tested my vitamin D levels for years and they were optimal based on Dr. Mercola's recommendations and I supplemented with D in the form of cod liver oil rarely.  Then I started taking iodine and I had such a dramatic improvement in symptoms that I knew I had been iodine deficient perhaps my entire life.  After 2-3 years of iodine supplemention I am going to get my D levels tested soon.

  • Anonymous

    12/20/2010 12:10:49 PM |

    Susanne
    Please write the name of the test you underwent to find iodine deficient?Is it a routine blood test that nay primary care doc can order?Readers please chime in please

    Regards
    SMK

  • Pater_Fortunatos

    12/20/2010 1:02:01 PM |

    Published less than a month ago:

    Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability

    http://arthritis-research.com/content/12/6/R216

  • Anonymous

    12/20/2010 9:58:20 PM |

    "Probably too cold to lay out in a bathing suit."

    Did you try without?
    OK, couldn't resist.

  • Anonymous

    12/20/2010 10:21:05 PM |

    Just a quick question about D3 supplements. I know that dry tabs aren't ideal because they're hard for the body to absorb but what about capsulated powdered D3?

  • Anonymous

    12/21/2010 1:34:06 AM |

    Have an observation using a vitamin D light that I thought to mention.  I take vitamin D capsules and have been doing so for around 5 years.  This winter I decided that I would also use a vitamin D3 light pretty much each day in addition to taking the capsules.  I bought a light sold on Dr Cannell's sight.  I've noticed that sunlight and the artificial D3 light makes me feel warm through out the day, something D3 isn't able to do for me, at least.  And with this cold fall/winter going on right now, this 10 minutes of sunlight is a big plus!    

    Well, there might be a nice bonus from using the light.  I think I'm growing bigger, in a muscular way.  I do work out at a gym and have done so for over 1 years.  Just began the slow burn process last week.  But this muscle growth seems to have started around the time I made a conscious effort to use the indoor light or obtain some sunlight.  

    Anyway, no way to prove, and could be completely wrong about this.  Just something I've noticed as my shirts have grown tighter over the last couple months.  Weight has gone up also by a few pounds. I'm pleased.

  • Jessica

    12/22/2010 7:29:50 PM |

    SMK- the test for iodine that we order in our clinic (family practice) is an iodine loading 24 hour urine test.

    patients take 50 mg of iodoral then capture their urine for the next 24 hours to see how much is excreted.

    There is a 2 week prep, though, that helps ensure the test is accurate.

    Dr. Brownstein (?) has several books on the topic. I think he recommends the load testing method in his book, "Iodine, why we need it, why we can't live without it."

  • Chris Masterjohn

    12/23/2010 2:10:47 AM |

    I'll be posting my comments on the IOM report soon, although this sucker is 999 pages long and taking me a while to read.  I don't think it is at all true that it focuses on "deficiency" instead of "optimal levels."  I think it is quite clearly and very explicitly focused on optimal levels.  

    The IOM claims to not have found sufficient evidence to conclude that higher levels are optimal.  Now, I do believe that there is good enough evidence to act on the hypothesis that levels should be above 30 ng/mL, and my impression so far is that there is very little data supporting an argument for >50 ng/mL as some suggest.  That said, I won't be convinced that the IOM is *wrong* that definitive evidence for greater than 20 ng/mL is lacking until I finish reading the report and look at some of the primary references.

    I do think it's important, however, to exercise the freedom to act on hypotheses.  If we needed definitive evidence for everyone we do, our familial relations and whole lives would fall apart.  Still, I think the IOM had a responsibility to assess the quality of the evidence and only solidify what is definitive into recommendations, as long as those recommendations don't preclude the freedom to use higher levels.

    In any case, hopefully I can finish this bad boy in the next week and blog about it.

    Chris

  • Anonymous

    12/24/2010 3:43:54 AM |

    Isn't anyone concerned about all those studies summarized in the IOM report showing increased mortality at the highest D levels? 50 ng/ml is the highest level that I can justify targeting.

  • Lacey

    12/24/2010 3:17:52 PM |

    Off topic, but...I wish Paleo bloggers were better at spotting and stopping spam comments.

    Blogger Brooklyn said...Awesome Blog!!! blah blah blah blah

    Funny, Brooklyn had the exact same words to say over on Stephan Guyanet's blog:  http://tinyurl.com/2v25wc3

    His wonderful blog that he links back to says, among other things, "In the meantime, they recommend that all people, with or without diabetes, should have a healthy balanced diet, low in fat, salt and sugar with plenty of fruit and vegetables." It's also chock full of plagiarized text.

    Sincere paleo fan or linkspammer?  You be the judge.

  • Travis Culp

    12/25/2010 4:38:25 AM |

    Has anyone tested vitamin D levels in indigenous people? I try to dose about 30 minutes a day of sun during solar noon without a shirt on during the summer and 5000 IU a day for the rest of the year. No idea what my level would be though.

  • Peter

    12/25/2010 12:45:12 PM |

    I'm more concerned about official organizations going beyond the evidence (eat margarine! eat carbs! avoid saturated fat!) than  being over-cautious when there's not a lot of reliable research.

  • Anonymous

    1/4/2011 4:26:38 AM |

    One more comment on my apparently deleted comment - there's a possibiliy I never typed in the word verification code, but I believe I did actually post the comment. Sorry, if I did falsely accuse.

  • Brad Fallon

    3/5/2011 6:08:50 PM |

    Vitamin D Deficiency, what is the best natural source apart from sunshine to help keep the levels up?

  • Anonymous

    3/21/2011 4:15:01 PM |

    I just found my new vitamin store. The prices are the lowest I could find. They gave me a free gift of $5.00 with no minimum purchase and I got free shipping! The code I used at checkout is WIR500. Maybe it will work for you too?

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